FORM NO. 5
[See rule 8A(d)]
Certificate of planting/replanting tea bushes

TEA BOARD
Certificate No. _______________
This is to certify that _______________________________________________________________ [name of assessee] has:
(a) planted tea bushes on land not planted at any time with tea bushes, or on land which had been previously abandoned;
(b) replanted tea bushes in replacement of tea bushes that have died or have become permanently useless, on any land already planted.
Necessary particulars are given here under :
* 1.Particulars of planting referred to in (a) above:
Sl. No. Name of tea
estate where
planting is done
Whether the tea estate referred
to in col.2 is situated in an area
declared by the Central Board
of Direct Taxes to be a “hilly
area" u/s 33A(8) of the Income tax
Act; and, if so, specify the
area
“Previous year" that is
the accounting year of
the assessee in which
the land was prepared
for planting
Extent of land (in
hectares) on which
planting is done
Date on which
planting
operations were
commenced
Whether notice of
commencement of planting
operations had been given in
writing to the tea board within
the period specified in rule
8A(a)
1 2 3 4 5 6 7
* 2. Particulars of replanting referred to in (b) above
Sl. No. Name of tea
estate where
replanting is
done
Whether the tea estate
referred to in col.2 is
situated in an area declared
by the Central Board of
Direct Taxes to be a “hilly
area" u/s 33A(8) of the
Income-tax Act; and, if so,
specify the area
“Previous year" that
is the accounting
year of the assessee
in which the land
was prepared for
replanting
Extent of land (in
hectares) on which
replanting is done
Date on which
replanting
operations
were
commenced
Whether notice of
commencement of
replanting operations
had been given in writing
to the tea board within
the period specified in
rule 8A(a)
Date on which
replanting
operations were
completed
1 2 3 4 5 6 7 8
Place ______________
Date ______________ (SEAL)
*Delete if either (a) or (b) is not applicable.